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HomeMy WebLinkAbout328371 08/08/18 CITY OF CARMEL, INDIANA VENDOR: 372573 ® ONE CIVIC SQUARE GUSTAVO JIMENEZ CHECKAMOUNT: $********44.48* CARMEL, INDIANA 46032 2200 WEST SEDBURY DRIVE CHECK NUMBER: 328371 APT.B15 CHECK DATE: 08/08/18 BLOOMINGTON IN 47403 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4343004 MILEAGE 44.48 TRAVEL PER DIEMS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 372573 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER GUSTAVO JIMENEZ IN SUM OF$ CITY OF CARMEL 2200 WEST SEDBURY DRIVE An invoice or bill to be properly itemized must show:kind of service,where performed,dates service APT. B15 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. BLOOMINGTON, IN 47403 Payee $44.48 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Department of Law Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT Mileage 43-430.04 $44.48 1 hereby certify that the attached invoice(s),or 7/27/18 Mileage $44.48 1180 101 1180 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Friday,July 27,2018 I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer t PRESCRIBED BY STATE BOARD OF ACCOUNTS MILEAC�F CLAIM TOVO City of Carmel, Indiana (GOVERNMENTAL UNIT) ON ACCOUNT OF APPROPRIATION NO. 434-3004 FOR Mileage Department of Law - 1180 (OFFICE,BOARD,DEPARTMENT OR INSTITUTION DATE FROM TO SPEEDOMETER AT READING + NATURE OF BUSINESS M1 2� - POINT POINT START FINISH TRAI avh� 'RA for u C` ou4 cn 1�J cr C ov-V 8 lw Cot,%((� ( v COU u ur C k- vIAf� 8 l 1 ur t (. 25 aSktqoWar Coma. , S SU c- \\ AUTO LICENSE NO. TOTALS �` ) + SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highway map. d Pursuant to the provisions and penalties of Chapter 155,Acts 1953,I hereby certify that the foregoing account is just and correct, that the amount claimed is legally due, after allowing -aud that no part of the same has been paid. Date